Abstract Created and maintained by the Boston University Alumni Medical Library, this web-based tutorial designed for self-study can be completed in approximately 5 minutes and can be used to support ...evidence-based medicine (EBM) practice and curricular components. The major educational topics addressed include the impact of the clinical question on EBM research, the key elements of a clinical question, how to form an answerable clinical question, and the role of the clinical question in the overall EBM process. Geared towards evidence-based practitioners and medical students (graduate and undergraduate), this tutorial is structured around an otitis media case. Through the step-by-step identification of the patient, intervention, comparison, and outcome (the PICO process), the case actively guides users in building an answerable clinical question. Due to the tutorial's interactive nature, users are engaged throughout and are asked to input information that is later revisited so they can note their progress. To ensure quality, the tutorial was reviewed by a family medicine physician. Links to related guides and worksheets are provided.
Medical education increasingly relies on small-group learning. Small group learning provides more active learning, better retention, higher satisfaction, and facilitates development of ...problem-solving and team-working abilities. However, less is known about student experience and preference for different small groups teaching models. We evaluated group educational dynamics and group learning process in medical school clerkship small group case-based settings, with a faculty member present versus absent.
Students completed surveys after cases when the faculty was present ("in") or absent ("out") for the bulk of the discussion. 228 paired surveys (114 pairs) were available for paired analysis, assessing group dynamics, group learning process, student preference, and participation through self-report and self-rating of group behaviors tied to learning and discussion quality.
Ratings of group dynamics and group learning process were significantly higher with the faculty absent vs. present (p range <0.001 to 0.015). Students also reported higher levels of participation when the faculty member was absent (p = 0.03). Students were more likely to express a preference for having the faculty member present after "in" case vs. "out" case discussions. (p < 0.001). There was no difference in reported success of the case discussion after "in" vs. "out" cases (p = 0.67).
Student groups without faculty present reported better group dynamics, group learning processes, and participation with faculty absent. Students reported that they feel somewhat dependent on faculty, especially when the faculty is present, though there was no significant difference in students reporting that they obtained the most they could from the discussion of the case after both "in" and "out" cases.
Continuing medical education (CME) has not taken advantage of the ability to communicate and collaborate online. Collaborative learning is an important learning principle, yet online CME programs are ...generally completed in a one-on-one relationship between the computer and the learner. This limits opportunities for reflective learning, and does not access the rich learning available from interacting with peers. We believe online CME will benefit from interaction between learners and from opportunities for reflection.
We implemented a prototype online course designed to improve the skills of general practitioners (GPs) in the care of patients with type 2 diabetes. The course design reflects adult learning principles but, uniquely, applies them to online learning. Currently, 20 GPs from England are enrolled, including one based in Bosnia, and one GP from New Zealand. The course uses BlackBoard(TM) software. Participants log in twice weekly for seven weeks to study one of seven interactive modules on diabetes from evidence-based sources. Modules provide for branched learning via links to additional resources. Subsequently, GPs engage in two online discussions, which are at the learner's convenience rather than requiring adherence to a set schedule. One discussion group is for reflection on the modules, with an assignment to discuss how the material is being applied clinically. Participants also respond to colleagues' postings each week. In a second discussion group, learners apply concepts from the modules to the collaborative management of a problem-based case of a patient with newly diagnosed diabetes. The patient is presented via an online medical chart and streaming videos. She returns each week of the course to mimic 18 months of care. Faculty facilitate the discussion groups and provide feedback.
We are in the last week of the class and the participant feedback has been overwhelmingly positive. Many note how well the course design and timing match their learning styles and schedule constraints. A powerful feature has been our ability to identify additional educational needs, and quickly add corresponding content online. So far, participants have provided 340 postings, which include evidence of course effectiveness and documentation of application of course objectives and disease management strategies to change actual practice patterns. GPs report changing: screening practices for diabetic renal disease; prescribing of diabetic medications; screening protocols for diabetes; and organizing practice management systems to better track diabetic care. After diagnosing and managing a new diabetic patient during the course, one participant wrote: "It was fantastic to feel that I am offering an up-to-date evidence-based approach in something that I am deskilled in." This course is unique in online CME. It is international in scope, collaborative, asynchronous in delivery, flexible, responsive to learner needs in real time, and has yielded evidence of its effectiveness in changing the actual clinical practices of participants. It will next enroll GPs in Singapore and additional UK-based GPs. Additional CME courses will be developed using this method.
The Comparative Experiences of Women in Control Mitchell, Suzanne E.; Mako, Morgan; Sadikova, Ekaterina ...
Journal of diabetes science and technology,
11/2014, Letnik:
8, Številka:
6
Journal Article
Recenzirano
Purpose:
The purpose was to characterize participants’ experiences of a diabetes self-management (DSM) education program delivered via a virtual world (VW) versus a face-to-face (F2F) format.
...Methods:
Participants included a randomly selected sample of participants who completed the Women in Control study. Four focus groups were conducted with 32 participants. Four researchers coded the data and conducted a qualitative thematic analysis.
Results:
Four overarching themes were identified. Three domains apply to both VW and F2F formats, including (1) the value of DSM knowledge gained, (2) cultivating DSM attitudes and skills, and (3) the value of peer-derived social support. The fourth domain is labeled positive technological development for DSM (VW condition only). VW and F2F groups both reported mastery of DSM knowledge, attitudes, and skills, and there were no differences in peer-derived social support between groups. The technological aspects of VW participation afforded VW participants a unique sense of personal agency and diabetes self-efficacy not reported by F2F participants.
Conclusions:
DSM education in a VW is feasible and educational outcomes are similar to a F2F classroom experience. Furthermore, learning DSM skills in a VW offers unique advantages in supporting personal agency for health behavior change. Further research is warranted.
There is a national shortage of primary care physicians; many medical school departments of family medicine are searching for new ways to attract and retain students who may be interested in primary ...care. In 2004, our department began a "pipeline" program targeted at entering first-year students that incorporates curricular, extracurricular, summer, and career-planning elements.
The program was evaluated and data collected on the numbers of students who were regular attenders of events, who expressed intent to apply in family medicine at the end of third year, and who ultimately matched in family medicine. Qualitative measures of program success were also noted (comments from students outside the department and the influence of the family medicine interest group).
Data are preliminary but suggest that the Family Medicine Student Track (FaMeS) has increased the numbers of students matching in family medicine from Boston University (BU) during a period when the national average was decreasing. The odds of a BU student matching in family medicine were nearly double (1.94) the odds compared with before the program. The family medicine interest group substantively increased its presence at the medical school and won a national Program of Excellence award.
The FaMeS program appears to be associated with a significant increase of numbers of students matching in family medicine during a time period when the national average decreased. The program is young, and results may be most generalizable to schools, like BU, with a strong specialist presence.
Boston University School of Medicine’s Finding Information Framework was created to help medical students structure and categorize their clinical questions and then link them directly to the most ...appropriate information resource. This tool has been developed into a mobile application to reinforce this framework, allowing immediate utilization of evidence-based medicine (EBM) tools.
We addressed a lack of geriatric content in our third-year family medicine clerkship. Adding this content posed a challenge in that students are dispersed to clinical sites across New England. Our ...goal was to promote student skill in functional assessment of elderly patients.
We used multiple formats: a workshop, a small-group case discussion, an online video, and an online discussion of a new geriatric case. Students were directed to use five assessment tools on actual patients in the office and on a home visit.
A total of 155 students participated in the new curriculum. Students completed a required home visit on an older patient and evaluated geriatric patients in an office setting. They performed the Mini-Mental State Exam (MMSE), Activities of Daily Living Scale (ADL), Instrumental Activities of Daily Living Scale (IADL), Geriatric Depression Scale (GDS), and Get-Up-and-Go tests in patients in both settings. There was significant improvement from before to after the clerkship in identification of the appropriate geriatric assessment tool to use (MMSE 86% to 96%; ADL/IADL 32% to 94%; GDS 71% to 94%, and Get-Up-and-Go 4% to 58%). Students evaluated the curriculum positively.
We were able to successfully increase the correct selection of and document high rates of use of geriatric functional assessment tools in our third-year family medicine clerkship using a mixture of teaching methods.
Wiecha et al used a survey to compare the diets of Vietnamese students with those of other students and to measure how diet changes with acculturation. Vietnamese students reported more frequent ...consumption of fruits and vegetables than did other students, but they were less likely to have three or more servings of dairy daily.
The ability to recognize and respond to the ethical dimension of medicine is integral to providing health care that is comprehensive and humane. However, this aspect of medical practice is ...underemphasized in clinical and academic medicine, despite attempts to devise curricula in this field. This paper examines the origins and consequences of this deficiency through a case history of a Jehovah's Witness who reluctantly accepted a blood transfusion. It emphasizes the ubiquity of the ethical context in medicine and argues that blindness to this context stems from the prevailing scientific and technological paradigm in medicine. Innovations in medical education are called for to enhance health care providers' abilities to appreciate and cope with these complex situations.
Dietary patterns of Asian Americans change with increasing acculturation, leading to increased consumption of Western foods including those high in fat. Strategies to preserve the healthy aspects of ...traditional diets need to be developed and dietary assessment methods evaluated. Little is known about reliability of brief dietary measures in the general population or among minority youth. The concurrent reliability of a brief food frequency questionnaire (FFQ) was determined among Vietnamese youth using diet reports. Students in a bilingual high school program were given a FFQ. Students then completed daily diet reports one day each week over seven weeks. The data from the FFQ were compared to the daily food reports. The reliability of the FFQ was highest for frequently eaten food types like rice (r=0.626, P<0.01), fruit (r=0.513, P<0.01), meat (r=0.525, P<0.01) and vegetables (r=0.474, P<0.01) and was lower for less commonly eaten types including fish/shellfish (r=0.227, P=0.20) and fried foods (r=0.310, P=0.07). These results suggest that a few simple FFQ items, particularly for indicator foods such as rice, are reliable for dietary assessment in this population.
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